This 2020 electron microscope made available by the U.S. Centers for Disease Control and Prevention image shows the spherical coronavirus particles from the first U.S. case of COVID-19. The Canadian Paediatric Society is closely monitoring reports of an inflammatory syndrome among some kids also diagnosed with COVID-19.THE CANADIAN PRESS/AP-C.S. Goldsmith, A. Tamin/ CDC via AP

This 2020 electron microscope made available by the U.S. Centers for Disease Control and Prevention image shows the spherical coronavirus particles from the first U.S. case of COVID-19. The Canadian Paediatric Society is closely monitoring reports of an inflammatory syndrome among some kids also diagnosed with COVID-19.THE CANADIAN PRESS/AP-C.S. Goldsmith, A. Tamin/ CDC via AP

Canadian Paediatric Society eyes mysterious syndrome for suspected COVID links

Symptoms of Kawasaki disease include dark red rashes that come and go, high fever, and swelling in the palms and feet

The Canadian Paediatric Society is closely monitoring reports that COVID-19 may be linked to a strange inflammatory syndrome in some children.

The society says it expects to issue advice to clinicians late this week or early next about symptoms similar to Kawasaki disease, although a COVID-19 connection has not been established.

A broad study is underway with the Canadian Paediatric Surveillance Program to detect how, and how many, children are being severely affected by COVID-19. A spokeswoman says that would include any cases that suggest Kawasaki disease, the primary cause of acquired heart disease among children.

Symptoms of Kawasaki disease include dark red rashes that come and go, high fever, and swelling in the palms and in soles of the feet. Patients can also develop lymph nodes on the neck, and inflammatory markers in the blood.

An infectious diseases pediatrician at Sainte-Justine Hospital in Montreal says COVID-19 is believed to be a factor in more than a dozen cases of Kawasaki-like illness there.

Dr. Fatima Kakkar says the cases emerged over the last three to four weeks and that it’s unusual to see so many within that time period.

None of the kids tested positive for an active COVID-19 illness, but because Kawasaki is believed to be triggered by a viral infection, she says doctors suspect there may have been a past COVID infection that was never detected.

Typically, Kawasaki disease cases emerge once every two weeks at most, Kakkar added.

“Thanks to the containment and social isolation (measures), there are no other viruses circulating,” Kakkar said Wednesday.

“We definitely don’t want to make the 100-per-cent link because we don’t have that proof yet, but it is suspicious. And I think with the other countries coming up with their data, it does raise the fact that the most likely virus circulating right now is actually COVID.”

ALSO READ: British Columbians can double their ‘pandemic bubble’ mid-May, but no large gatherings

Similar cases have been reported in the United States and Europe. This week, New York City’s health department issued an alert about 15 cases, and stressed that early recognition and specialist referral was “essential.”

Kakkar says she and her colleagues must now determine whether the patients — who range in age from one year to late teens and have all recovered — had a past COVID-19 infection, but antibody tests are not yet available in Canada.

She says efforts are underway to get a clinical test validated, or test the children as part of a research protocol.

“These kids would have had to have had their infections weeks ago, cleared the infection, and now it would be the body’s immune system sort of hyper-responding to the infection,” Kakkar guesses.

“The closest we’ve come to identifying COVID is when we see that, for example, the child’s negative but the parents are COVID-positive.”

Canada’s chief public health officer also addressed the issue Wednesday, cautioning parents that children with COVID-19 have mild symptoms and that severe outcomes are very unusual.

Still, Dr. Theresa Tam said parents who are concerned should contact their health-care provider.

“Pediatricians are very aware of Kawasaki disease because it actually happens with other viral illnesses and infections as well. So it’s not specific to COVID-19 and they would know how to manage that.”

The questions arise while much of Quebec prepares to gradually reopen daycare and elementary schools Monday, with the Greater Montreal area set to reopen May 19.

But Kakkar suggested the emerging mystery around Kawasaki-like symptoms is not enough to derail those plans.

“Compared to the numbers of kids who’ve had COVID, this is a very rare complication,” says Kakkar.

Kawasaki is diagnosed through a combination of clinical signs and blood markers, with a set number of criteria that define classic symptoms.

The suspicious patients are considered “atypical Kawasaki” cases because they have some, but not all of the criteria, says Kakkar.

That includes the fact many are older, when Kawasaki typically strikes before age 6.

“That’s what puzzled us on the wards the last few weeks,” she says. “It is important for all the other doctors and the parents to be aware of these bizarre symptoms.”

Like COVID-19, there is still much to learn about Kawasaki disease, she adds.

“We think it’s a viral or a bacterial trigger, but we don’t really know — is it something genetic? Is there an immune trigger? Is there something that’s changed in the environment? We don’t know.”

Cassandra Szklarski, The Canadian Press


@katslepian

katya.slepian@bpdigital.ca

Like us on Facebook and follow us on Twitter.

CanadaCoronavirus

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

Kennedy Nikel, applied marine biologist at Cascadia Seaweed, here seen in late September, shows off bull kelp (in her left hand) and rock weed. The company is spear-heading an annual seaweed festival scheduled for May 13-21, 2021, with Sidney council have signed off in principle. (Wolf Depner/News Staff)
Cascadia hopes to see Sidney host seaweed festival in May 2021

Council supports the idea in principle following a presentation by Cascadia Seaweed

GIF
’90s rock band resurfaces with songs never properly recorded or released

Underwater Sunshine’s online reunion involves four guys who lost contact for years

Tim Siebert, one half of the partnership behind Citrus & Cane, says opening the Douglas Street cocktail lounge during a pandemic had challenges, but the bar is ready to adapt to whatever comes next. (Nina Grossman/News Staff)
New Victoria tropical cocktail lounge designed with COVID-19 safety in mind

Citrus & Cane opens in site of former Copper Owl after eight-month delay

Trevor Davis, base manager of the Western Canada Marine Response Corporation in Sidney, stands in front of the Hecate Sentinal, an oil skimming vessel based at Sidney’s Van Isle Marina. (Wolf Depner/News Staff)
Oil spill response base taking shape on Saanich Peninsula

Enhanced base with elements in North Saanich and Sidney to be fully operational in fall 2022

Idyllic winter scenes are part of the atmosphere of the holiday season, and are depicted in many seasonal movies. How much do you know about holiday movies? Put your knowledge to the test. (Pixabay.com)
QUIZ: Test your knowledge of holiday movies and television specials

The festive season is a time for relaxing and enjoying some seasonal favourites

Black Press Media and BraveFace have come together to support children facing life-threatening conditions. Net proceeds from these washable, reusable, three-layer masks go to Make-A-Wish Foundation BC & Yukon.
Put on a BraveFace: Help make children’s wishes come true

Black Press Media, BraveFace host mask fundraiser for Make-A-Wish Foundation

A man walks by a COVID-19 test pod at the Vancouver airport in this undated handout photo. A study has launched to investigate the safest and most efficient way to rapidly test for COVID-19 in people taking off from the Vancouver airport. The airport authority says the study that got underway Friday at WestJet’s domestic check-in area is the first of its kind in Canada. THE CANADIAN PRESS/HO, Vancouver Airport Authority *MANDATORY CREDIT*
COVID-19 rapid test study launches at Vancouver airport for departing passengers

Airport authority says that a positive rapid test result does not constitute a medical diagnosis for COVID-19

A small crash in the water south of Courtenay Saturday afternoon. Two men had to be rescued, but reports indicate there were no serious injuries. Photo by Mike Chouinard
Small plane crash in Comox Valley waters Saturday afternoon

Two rescued from plane that had flipped in water; no serious injuries reported

A photo from 2017, of Nuchatlaht First Nation members outside court after filing a land title case in B.C. ( Submitted photo/Nuchatlaht First Nation).
Vancouver Island First Nation calls on B.C. to honour UNDRIP in historic title case

Nuchatlaht First Nation says Crown counsel continues to stall the case using the ‘distasteful’ argument that the Nation ‘abandoned’ their land

West Vancouver Island’s Ehattesaht First Nation continues lock down after 9 active cases were reported today after a visitor tested positive last week. (Ehattesaht First Nation/Facebook)
Ehattesaht First Nation’s COVID-19 nightmare: nine active cases, a storm and a power outage

The Vancouver Island First Nation in a lockdown since the first case was reported last week

114 Canadians were appointed Nov. 27 to the Order of Canada. (Governor General of Canada photo)
Indigenous actor, author, elder, leaders appointed to Order of Canada

Outstanding achievement, community dedication and service recognized

The Ahousaht First Nation confirmed its first case of COVID-19 on Nov. 26, 2020. (Westerly file photo)
Ahousaht First Nation on lockdown over COVID-19

“Emotions are high. The anxiety is high. We want our community to pull through.”

Most Read